A patient who stops taking an ACE inhibitor because of its side effects will begin taking an angiotensin II receptor blocker (ARB) medication. Which side effect of ACE inhibitors will not occur with an ARB medication?

Dry cough

Hyperkalemia

Hypotension

Angioedema

Answer and Explanation

The Correct Answer is A

Choice A reason: ACE inhibitors cause dry cough by inhibiting bradykinin breakdown, which accumulates and irritates the airways. ARBs block angiotensin II receptors without affecting bradykinin, eliminating this side effect. This makes ARBs a suitable alternative for patients experiencing cough, confirming this as the correct choice.

Choice B reason: Hyperkalemia occurs with both ACE inhibitors and ARBs due to reduced aldosterone production, which decreases potassium excretion. Both drug classes affect the renin-angiotensin-aldosterone system similarly, so switching to an ARB does not eliminate this risk, making this choice incorrect for the question.

Choice C reason: Hypotension is a shared side effect of ACE inhibitors and ARBs, as both reduce blood pressure by inhibiting the renin-angiotensin system. ARBs block angiotensin II receptors, causing vasodilation similar to ACE inhibitors, so this side effect persists, making this choice incorrect.

Choice D reason: Angioedema, though rare, can occur with both ACE inhibitors and ARBs. While less common with ARBs, it’s not eliminated, as it may result from mechanisms beyond bradykinin accumulation. Switching to an ARB doesn’t guarantee avoidance of angioedema, making this choice incorrect.

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Correct Answer is B

Explanation

Choice A reason: Jaundice indicates liver dysfunction, but ibuprofen rarely causes hepatotoxicity at standard doses. It’s more associated with gastrointestinal issues due to COX-1 inhibition, reducing protective prostaglandins in the stomach lining. While possible with overdose, jaundice is less common than gastrointestinal bleeding, making this choice less likely.

Choice B reason: Ibuprofen, an NSAID, inhibits COX-1, reducing gastric mucosal protection, which can lead to ulcers or gastrointestinal bleeding. Bloody emesis (hematemesis) indicates severe gastrointestinal damage, a well-documented adverse effect requiring immediate intervention, making this the correct choice for a severe ibuprofen-related complication.

Choice C reason: Itching may indicate a mild allergic reaction or skin irritation, not a severe adverse effect of ibuprofen. While possible, it’s less critical than gastrointestinal bleeding, which poses life-threatening risks due to ibuprofen’s impact on gastric mucosa, making this choice less severe and incorrect.

Choice D reason: Dysmenorrhea (painful periods) is a condition ibuprofen treats, not an adverse effect. By inhibiting prostaglandins, ibuprofen reduces uterine contractions and pain. It doesn’t cause dysmenorrhea, making this choice irrelevant as an indicator of a severe adverse effect of ibuprofen therapy.

A. Pulse oximetry reading of 95% B. Respiratory rate of 22 breaths per minute C. Blood pressure of 100/60 mm Hg D. Heart rate of 120 beats/min

Correct Answer is D

Explanation

Choice A reason: Pulse oximetry of 95% is near normal and not a major concern for beta agonist administration. Tachycardia is more critical due to cardiac stimulation, so this is incorrect.

Choice B reason: A respiratory rate of 22 is slightly elevated but acceptable in respiratory conditions. Beta agonists target airways, but tachycardia is a greater risk, making this incorrect.

Choice C reason: Blood pressure of 100/60 mm Hg is low, but beta agonists primarily affect heart rate. A pre-existing tachycardia is more concerning contraindication, so this is incorrect.

Choice D reason: A heart rate of 120 beats/min is concerning, as beta agonists increase heart rate, risking arrhythmias. This requires evaluation before administration, making it the correct concern.

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A patient who stops taking an ACE inhibitor because of its side effects will begin taking an angiotensin II receptor blocker (ARB) medication. Which side effect of ACE inhibitors will not occur with an ARB medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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